Testosterone is the male sex hormone and is literally responsible for what makes us men (including genital development, height, muscle mass and facial hair during puberty), but it also does much more. In this blog, Dr Jeff Foster, Medical Director and Men’s Health Specialist at H3 Health, gives a reminder on why testosterone is so important to men’s health and what your options are if you think you may be suffering from low testosterone.
So what exactly is testosterone, and why is it so important?
Testosterone is the male sex hormone and is literally responsible for what makes us men (including genital development, height, muscle mass and facial hair during puberty), but it also does much more.
Testosterone acts on our muscles, fat cells, affects our cholesterol, blood pressure, bone density and even the way our brain works. It affects the way we think and influences drive, motivation, energy and mood.
In fact, testosterone has some impact on almost every aspect of our body. It is no wonder, therefore, that men can feel unwell when their levels drop.
Surely the solution to low testosterone is easy?
Surely if we feel terrible when our testosterone levels plummet, the answer is to just get some testosterone replacement therapy (TRT), and everything will be great? Well, yes and no. And not always.
We commonly have contacts and emails from many men who have independently taken a blood test (finger prick or from a vein), which comes back with an uncertain testosterone level, and whose first question is: “Am I eligible for TRT?” This should be a difficult question for any doctor to answer because TRT is the final part of an investigatory pathway and not the first.
If your doctor looks at your initial numbers and his first response is “Yes of course, let’s get you a prescription”, alarm bells should be ringing.
Understanding why you have low testosterone is key
For most men with a confirmed low testosterone, TRT is a prolonged treatment and is designed to put testosterone levels back into an appropriate clinical range. However, the question should always be “Why has my testosterone dropped in the first place?”
We know that age is a key factor in the decline in testosterone production. After the age of 30 men tend to lose about 1% of their testosterone production per year, although this can be sped up or slowed down based on lifestyle and medical factors. If this is the case, and other factors have been considered, then starting TRT may be a more straightforward process.
Another important contributor to low testosterone in men is obesity, which can have a significant effect on testosterone levels. But in practice the list of factors that impact on testosterone production is vast, and a small sample includes:
Type 2 diabetes
High Blood Pressure
Liver, Kidney problems
Cancer and cancer treatments
Lung disease (including asthma)
Thyroid disease
Sleep patterns
Alcohol
Exercise (too little or too much)
Many prescription and non-prescription drugs
Finding the right solution
One of the main reasons we have doctors with a specialist interest in Men’s Health is because if you can find out why your testosterone is low, you may be able to improve this by changing a medication, getting a different treatment, or altering your lifestyle. If you are really lucky, it may mean you do not need TRT at all.
Going straight to TRT without looking at why your testosterone is low is a bit like stitching up a wound without knowing why you were bleeding in the first place.
A bit like HRT for menopause in women, testosterone replacement therapy for men can significantly improve symptoms in appropriately diagnosed men. But it is still a medicine, and requires blood monitoring, review with a doctor, and you may end up on treatment for many years.
Therefore, when considering clinics or treatment options, I would always ask the doctor: “I have done a blood test and I have low testosterone, can you help me work out why it is low, and what we can do together to put it right?”
Next steps…
If you’d like to talk to one of our men’s health specialists about low testosterone or any of the topics we’ve touched on you can make a booking here – to make it easy we offer consultations online or face to face, whichever you prefer.
